A high ankle-brachial index is associated with osteoporosis in the U.S. general population: A cross-sectional study

Vascular calcification or stiffness has been associated with osteoporosis. This study aims to investigate the relationship between lower limb arterial calcification or stiffness, measured by ankle-brachial index (ABI), and osteoporosis. A total of 3137 asymptomatic participants with complete ABI were enrolled from the NHANES 2001 to 2004 with an age of 53.37 ± 10.72 years; 51.56% were male and 48.44% were female. Logistic regression analysis was used to compute the odds ratios of osteoporosis in tertiles of ABI adjusted for traditional risk factors. Restricted cubic spline analyses were used to explore the dose-response correlation between osteoporosis or bone mineral density and ABI values. The uppermost ABI tertile was correlated with osteoporosis (adjusted odds ratios 2.76, 95% confidence interval 1.14 to 6.69; P = .02). ABI > 1.13 was associated with lower lumbar spine bone mineral density and higher prevalence of osteoporosis. Based on the nationally representative U.S. population, our findings show that a higher ABI may be independently associated with a higher presence of osteoporosis, which suggests a possible relationship between arterial calcification or stiffness and osteoporosis.